Sudden-onset in Obstetrics & Gynecology — Case | General Gynecology | SMLE Q#11276

SMLE Question #11276

Obstetrics & Gynecology General Gynecology

Objective: OBJ-ETH-STERIL

Last updated: February 2026
A 28-year-old primigravida at 34 weeks of gestation presents with sudden-onset, constant severe lower abdominal pain for 2 hours and reduced fetal movements. She has no history of trauma or recent intercourse. Examination shows a tense, very tender abdomen with a rigid, board-like uterus and frequent contractions. Speculum and digital examination show a closed cervical os and no active vaginal bleeding. Fetal heart sounds are difficult to detect by Doppler. What is the most likely diagnosis?

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